In the Mile 46 area of Kajiado in southern Kenya, roads are few and public health facilities sorely lacking. This creates several problems, not least with the immunisation of children against tuberculosis, polio and measles.
As mothers in the area have to walk long distances to health facilities, they tend not to vaccinate their children, say health workers.
Neimesoi Lokore is a case in point. She has never taken her five-month-old son to be immunised. ”I and my baby have never been to any hospital. There is no hospital where I stay in Nangojet [in Mile 46],” she says, adjusting the baby strapped on her back.
”If I am to take the baby or myself to hospital, I would have to walk for eight hours to and from the nearest health clinic. I would rather stay home and cook for my husband because when he comes home, he wants his food. If it is not there, I will be beaten.”
Ignorance on the part of women about the importance of vaccinations compounds the problem, as does the lack of refrigerators at clinics to store vaccines.
However, the Africa Inland Church (AIC) — created in 1952 as the result of a missionary outreach into Kenya — is trying to address this situation in an innovative way. Through its dispensary in Kajiado, the AIC supports four mobile clinics in the region that bring healthcare closer to residents.
The first clinics began operating in 2001. Five years later, people like Sindima Kutata are reaping the benefits of the immunisation and antenatal services that they provide. Kutata was able to walk a relatively short distance to have her four-month-old baby vaccinated, something that would have been unthinkable previously.
”I have walked for only two hours to get here today. I will walk two hours back home. This is manageable,” the mother of six said earlier this month when she attended a mobile clinic in Mile 46.
”In the past I would have walked eight hours or more to get to a hospital. You see, even though it is hot, I do not feel tired because the clinic is close to us now,” Kutata added, smiling, and wiping her perspiring face.
The hope is that the clinics will put immunisation rates in Kajiado on a par with those in more developed areas. During an AIC Kajiado dispensary drive earlier this year to deworm children in the region, more than half of the approximately 400 children treated had never received basic immunisation.
Services provided by the mobile clinics are also affordable. Residents of Kajiado pay about seven United States cents for immunisation, while mothers coming for antenatal check-ups pay just more than 40 cents.
And for those who find even these prices too high, provision can be made. ”In such instances, we consider the cases. If they genuinely do not have money, we treat them, then tell them to go look for money. Because we sometimes get free medicines from the Ministry of Health, we are able to waive the fees for poor people,” says Julius Sazia, the nurse in charge at the AIC dispensary.
The situation at Loodokilani Health Centre, a government facility in Mile 46, further illustrates how valuable the services provided by mobile clinics are.
Residents who make use of the clinic and employees complain that it is understaffed. Just two health officers are on hand to attend to patients; they work alone, alternating shifts.
”I am supposed to do antenatal care, immunisations and also test the pregnant mothers for HIV … [but] I am just one person,” says Anne Parsitan, a nurse at the centre, where a line of pregnant women can be seen waiting, near mothers with crying babies in need of vaccinations. Outside, couples wait to be counselled about HIV/Aids.
Saturday is the busiest day at Loodokilani Health Centre, as it is a market day. Both Parsitan and her colleague, Abel Awuanda, attend to about 100 people on Saturdays.
At present, Kenya has a shortage of about 13 000 health workers, the majority of them nurses, according to Assistant Health Minister Wilfred Machage. Authorities say the World Bank and International Monetary Fund have required them to place an embargo on recruiting more workers.
But in the midst of staff shortages at Kenya’s hospitals and clinics, the government nonetheless spent millions of dollars on luxury vehicles for senior officials after coming to power in December 2002.
A report issued earlier this year by Transparency International, the anti-corruption watchdog, and the Kenya National Commission on Human Rights noted that authorities had paid out about $12-million in 2003 and 2004 to buy vehicles for ministers, their deputies and permanent secretaries. A directive was later issued for some of the cars to be returned.
More recently, Parliament voted to increase President Mwai Kibaki’s monthly salary substantially from about $27 000 to $46 000, inclusive of allowances — this in a country were about 56% of the population lives on less than $1 a day.
The increase, agreed earlier this month, sparked a public outcry.
”I do not understand how the government cannot put in electricity or invest in solar energy to enable clinics to offer basic services like immunisation, yet it can increase by big margins the salaries of its officers,” said Stanley Sayo, a resident of Sigiraini, about 20km from Mile 46. — IPS